Fraud Business Analyst SME

About this role

Fraud Business Analyst SME

Remote work

Preferred: US Citizenship

• Ability to obtain and maintain an HHS Background Investigation (Public Trust) suitability determination.

Key Responsibilities

Requirements Elicitation and Traceability

• Facilitate structured requirements workshops with HRSA program stakeholders (OIG, Grants Division, FDMP program office) to elicit and document business requirements for fraud detection, anomaly flagging, and case management workflows.

• Translate business requirements into user stories, acceptance criteria, and process flows; maintain a traceable requirements matrix (RTM) throughout the EPLC lifecycle.

• Review and validate EPLC planning deliverables (Business Requirements Documents, Concept of Operations, System Requirements Specifications) to ensure they accurately reflect HRSA’s fraud detection intent.

Fraud Domain SME Support

• Apply working knowledge of federal grant fraud, waste, and abuse (FWA) patterns to inform model design decisions: improper payment types, duplicate entity schemes, inflated cost reports, and sub-awardee integrity risks across HRSA grant programs.

• Support the AI/ML Lead Engineer in defining supervised classification labels, anomaly detection thresholds, and SHAP feature interpretation from a business-rules perspective.

• Validate model outputs and HITL review queues against known FWA patterns; flag false-positive risks and provide business-logic guardrails to data science team.

• Contribute to the design of the Portfolio Risk Manager agent’s risk scoring logic and grantee-level threshold calibration; ensure scoring outputs are interpretable and defensible for HRSA investigators.

Agile Delivery and Sprint Governance

• Own and maintain the product backlog in coordination with the Program Manager and AI/ML Lead Engineer; write well-formed user stories and acceptance criteria for all sprint deliverables.

• Facilitate Agile ceremonies including sprint planning, backl...